Delegate Voting Form

Certification of Delegates

TO: ALL MEMBERS OF THE ALLIANCE OF INDIANA RURAL WATER
FROM: Todd Gardner, PRESIDENT
DATE: July 16, 2018
TOPIC: ALLIANCE OF INDIANA RURAL WATER 37th ANNUAL MEMBERSHIP MEETING

The annual membership meeting of the Alliance of Indiana Rural Water is scheduled for
8:00 a.m. on Thursday, October 18th at the Grand Wayne Convention Center in Fort Wayne, Indiana.
During this meeting, four (4) members of the Alliance Board of Directors will be elected to fill four open Director seats.
I will appoint a nominating committee to present a slate of candidates at the annual meeting.
Any voting member of the Alliance, who wishes to be considered for election, may submit their name on the
nomination form.
Any voting member who follows these guidelines shall have their name placed on the ballot as seeking a position as a
Director of the Board. Per the Alliance by-laws, (see 2018 Resource Directory) THERE WILL BE NO NOMINATIONS FROM
THE FLOOR AT THE ANNUAL MEMBERSHIP MEETING. All directors elected at the membership meeting shall serve a three
(3) year term. Terms shall be based on calendar years, commencing on January 1 following the election.

In order to cast votes for potential board members, the certification of delegate form
must be completed and returned to the Alliance by Wednesday, October 17 at 9:00 a.m.

Article VI, Section 5, Voting:

“Each Active Member shall be entitled to one (1) voting delegate, in person, on each matter submitted to the delegates at each
annual or special meeting. Only one (1) vote per person. No employee of the Alliance may vote for a member system. All matters
presented to such annual or special meetings shall be decided by a majority vote there at. There shall be no voting by Proxy.”

Official name of member system

Delegate Name

Alternate Name

I hereby certify the individual listed herein is the designated official voting delegate / alternate to the Alliance of Indiana Rural
Water Membership Meeting.

YesNo

I hereby certify that the delegate meets the criteria of the Alliance of Indiana Rural Water by-laws under Article VI / Section 6 which states -
“Each delegate / alternate shall be an active user or employee of the system he / she represents.”

About Us

The Alliance of Indiana Rural Water is a non-profit membership association of over 800 water & wastewater systems and related professionals and Indiana's ONLY representative to the National Rural Water Association.

Contact Us

If you have any questions, please call or e-mail us. We will reply to you as quickly as we can.